JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Lessons Learned From the Integration of Ambient Assisted Living Technologies in Older Adults' Care: Longitudinal Mixed Methods Study.","authors":"Oteng Ntsweng, Martin Kodyš, Zhi Quan Ong, Fang Zhou, Antoine de Marassé-Enouf, Ibrahim Sadek, Hamdi Aloulou, Sharon Swee-Lin Tan, Mounir Mokhtari","doi":"10.2196/57989","DOIUrl":"10.2196/57989","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has given impetus to an already growing trend around the use of ambient assisted living (AAL) technologies to support frail older adults who live alone. However, the challenge is that systematic research on the long-term use of AAL technologies remains in its nascent stages, leaving gaps in the understanding of the predictors that contribute to the routine embedding of AAL technologies in older adults' care.</p><p><strong>Objective: </strong>This paper aims to share key lessons from a longitudinal study on the routine embedding of AAL technologies in older adults' care within a hitherto under-studied Southeast Asian context. Our objective was to design and deploy an AAL system termed Ubiquitous Service Management and Reasoning Architecture (Ubismart), evaluate its impact on older adults' quality of life (QOL), and distill lessons to inform the sustainable and culturally sensitive adoption of AAL technologies in similar settings.</p><p><strong>Methods: </strong>We conducted an in-depth case study using a mixed methods design. First, we designed and deployed Ubismart to unobtrusively monitor and visualize older adults' activities of daily living. To assess changes in QOL, we administered a simplified, gamified version of the validated Older People's Quality of Life Questionnaire. Finally, we conducted semistructured interviews with older adults and their caregivers to triangulate the quantitative findings and explore evolving perceptions of the technology and its integration into daily routines.</p><p><strong>Results: </strong>Quantitative analysis revealed significant improvements in (1) psychological and emotional well-being (P=.01) and (2) leisure and social activities (P=.03) following the AAL intervention. Other QOL dimensions showed no statistically significant change. Qualitative findings reinforced the improvement in psychological and emotional well-being, with many participants describing a heightened sense of safety and peace of mind, often likening the technology to \"insurance\" or a silent companion. However, the impact on social relationships was paradoxical; some older adults felt more cared for, while others perceived a decline in in-person visits. This paradox highlighted the complexities of technology's role in caregiving, as it might simultaneously enhance feelings of safety while unintentionally diminishing social connection for some older adults.</p><p><strong>Conclusions: </strong>AAL technologies such as Ubismart enhance older adults' psychological and emotional well-being and sense of safety but may inadvertently reduce social interaction. Sustainable integration requires balancing these benefits with efforts to maintain meaningful caregiver connections, supporting both safety and social engagement for older adults.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06486935; https://clinicaltrials.gov/study/NCT06486935.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e57989"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Robot-Assisted Upper Extremity Function Training (Gloreha) on Upper Extremities Function After Stroke: Systematic Review.","authors":"Chirathip Thawisuk, Sopida Apichai, Waranya Chingchit, Jananya P Dhippayom, Teerapon Dhippayom","doi":"10.2196/68268","DOIUrl":"10.2196/68268","url":null,"abstract":"<p><strong>Background: </strong>The Gloreha (Idrogenet SRL) is a robotic device that enhances conventional rehabilitation for improving upper extremity function after stroke, but comprehensive evidence on its effectiveness is still lacking.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effectiveness of the Gloreha device on upper extremity function and activities of daily living (ADLs) in patients with stroke.</p><p><strong>Methods: </strong>PubMed, Cochrane CENTRAL, CINAHL, Embase, and EBSCO Open Dissertations were searched from January 2013 to January 2024. The inclusion criteria were randomized controlled trials involving adult patients with stroke that compared rehabilitation with the Gloreha device to conventional rehabilitation and reported upper extremity function or ADLs outcomes. All included studies underwent bias risk assessment using the Revised Cochrane risk-of-bias tool for randomized trials.</p><p><strong>Results: </strong>Out of 1123 studies identified, 3 randomized controlled trials involving 83 participants were included. Of these, 2 trials combined Gloreha training with conventional rehabilitation, while in another trial, patients engaged solely in the training by the Gloreha device. The Gloreha, whether integrated with conventional rehabilitation or used independently, has the potential to enhance motor function and functional ability in survivors of stroke.</p><p><strong>Conclusions: </strong>Gloreha passive training with conventional rehabilitation improves upper extremity function post stroke, but ADL effects and long-term optimal dosing require further research.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68268"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable-Enhanced mHealth Intervention to Promote Physical Activity in Manual Wheelchair Users: Single-Group Pre-Post Feasibility Study.","authors":"Zijian Huang, Dan McCoy, Rosemarie Cooper, Theresa M Crytzer, Yueyang Chi, Dan Ding","doi":"10.2196/70063","DOIUrl":"10.2196/70063","url":null,"abstract":"<p><strong>Background: </strong>With the rapid advancement of technology, using wearable devices and mobile health (mHealth) apps to monitor and promote physical activity (PA) has become increasingly popular among individuals with various chronic conditions. However, such work remains limited among individuals with spinal cord injury (SCI), especially those who use a manual wheelchair for mobility.</p><p><strong>Objectives: </strong>The study aims to describe the development of the WheelFit mHealth app for monitoring and promoting PA in manual wheelchair users (MWUs) with SCI and evaluate its feasibility and usability in free-living conditions.</p><p><strong>Methods: </strong>The WheelFit app, based on the Fogg Behavioral Model with inputs from stakeholders, including MWUs, physical therapists, and personal trainers, was developed to promote PA in MWUs. It works with two commercial wearable devices, that is, an Android smartwatch and a wheel sensor, which stream users' upper extremity and wheelchair movement to the app to calculate PA variables using custom algorithms. Users can set personal goals, review daily progress and PA history, and access an adaptive workout library within the app. A 4-week single-group pre-post study, consisting of a 1-week baseline and 3-week intervention phase, was conducted to evaluate WheelFit's feasibility and usability. Feasibility was evaluated using the session attendance rate, device and app usage, and implementation of action plans. Usability was assessed using the system usability scale. The preliminary effectiveness was assessed by comparing preintervention and postintervention PA variables and scores from the SCI exercise self-efficacy scale.</p><p><strong>Results: </strong>A total of 16 participants completed the study protocol with 100% session attendance and maintained 14.2 hours of daily device and app connection. Participants demonstrated varying levels of adherence to their action plans. The excellent usability of WheelFit was indicated by an average system usability scale score of 81.8 (SD 19.2) points. Statistically significant increases between pre-post daily exercise times (preintervention: mean 26.4, SD 16.9 minutes; postintervention: mean 33.3, SD 24.9 minutes; P=.049) and exercise self-efficacy scale scores (preintervention: mean 33.9, SD 4.5 points; postintervention: mean 35.9, SD 3.2 points; P=.043) were observed.</p><p><strong>Conclusions: </strong>The WheelFit app demonstrated promising feasibility, usability, and a positive impact on promoting PA in MWUs with SCI. Future investigation exploring the potential integration of the WheelFit app into clinical practice is warranted.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70063"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of ChatGPT for Urinary Symptom Management Among People With Spinal Cord Injury or Disease: Qualitative Study.","authors":"Bat-Zion Hose, Amanda K Rounds, Ishaan Nandwani, Deanna-Nicole Busog, Traber Davis Giardina, Helen Haskell, Kelly M Smith, Kristen E Miller","doi":"10.2196/70339","DOIUrl":"10.2196/70339","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury or disease (SCI/D) experience disproportionately high rates of recurrent urinary tract infections, which are often complicated by atypical symptoms and delayed diagnoses. Patient-centered tools, like the Urinary Symptom Questionnaires for Neurogenic Bladder (USQNB), have been developed to support symptom assessment yet remain underused. Generative artificial intelligence tools such as ChatGPT may offer a more usable approach to improving symptom management by providing real-time, tailored health information directly to patients.</p><p><strong>Objective: </strong>This study explores the role of ChatGPT (version 3.5) in supporting urinary symptom management for individuals with SCI/D, focusing on its perceived accuracy, usefulness, and impact on health care engagement and self-management practices.</p><p><strong>Methods: </strong>A total of 30 individuals with SCI/D were recruited through advocacy groups and health care networks. Using realistic, scenario-based testing derived from validated tools for symptom management with SCI/D, such as the USQNB, participants interacted with ChatGPT to seek advice for urinary symptoms. Follow-up interviews were conducted remotely to assess individuals' experiences using ChatGPT for urinary symptom management. Data were analyzed using inductive content analysis, with themes refined iteratively through a consensus-based process.</p><p><strong>Results: </strong>People with SCI/D reported high levels of trust in ChatGPT's recommendations, with all 30 participants agreeing or strongly agreeing with the advice provided. ChatGPT's responses were perceived as clear and comparable to professional medical advice. Participants mentioned concerns about the lack of sources and integration with patient-specific data. ChatGPT influenced individuals' decision-making by supporting symptom assessment and guiding participants on when to seek professional care or pursue self-management strategies.</p><p><strong>Conclusions: </strong>ChatGPT is a promising tool for symptom assessment and managing chronic conditions such as urinary symptoms in individuals with SCI/D. While ChatGPT enhances accessibility to health information, further research is needed to improve its transparency and integration with personalized health data to be a more usable tool in making informed health decisions.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e70339"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Wearable Technologies for Balance Rehabilitation in Older Adults at Risk of Falls: Scoping Review and Comparative Analysis.","authors":"Brooke Nairn, Vassilios Tsakanikas, Becky Gordon, Efterpi Karapintzou, Diego Kaski, Dimitrios I Fotiadis, Doris-Eva Bamiou","doi":"10.2196/69589","DOIUrl":"10.2196/69589","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Falls among older adults are a significant public health concern, often leading to severe injuries, decreased quality of life, and substantial health care costs. Smart wearable technologies for balance rehabilitation present a promising avenue for addressing the falls epidemic, capable of providing detailed objective movement data, engaging visuals, and real-time feedback. With the recent and rapid evolution of innovative technologies, including artificial intelligence (AI), augmented reality (AR) or virtual reality (VR), and motion tracking, there is a need to evaluate the market to identify the most effective and accessible smart balance systems currently available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate the current landscape of smart wearable technology systems for balance rehabilitation in older adults at risk of falls. In addition, it aims to compare market-available systems to the telerehabilitation of balance clinical and economic decision support system (TeleRehab DSS), a recently developed smart balance system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review and strengths, weaknesses, opportunities, and threats (SWOT) analysis was completed, exploring the landscape of smart balance systems in older adults at risk of falls. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, electronic databases PubMed, MEDLINE, and Cochrane were systematically searched for articles in English from July 1, 2014, to July 1, 2024. Gray literature searches of relevant institutions and web pages were also conducted. The database search and commercial systems were then compared against the TeleRehab DSS in a SWOT analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The scoping review yielded 17 systems that met the inclusion criteria; 10 investigational systems and 7 commercially available systems. Out of 10 studies, only 1 reported the use of intelligent learning or AI, 8 studies reported the use of motion tracking, and 9 studies used virtual reality. Of the studies incorporating motion tracking, 3 provided feedback as either visual or auditory. All but 2 studies reported the use of gamification, and 7 studies incorporated balance exercises. In total, 2 studies reported remote delivery, with 5 being clinician-supervised and 4 providing a clinician report. The SWOT analysis of TeleRehab DSS against the 7 market-available smart balance systems revealed several unique advantages, including personalized therapy with AI-DSS, AR for real-world interaction, enhanced clinician involvement, and comprehensive data analytics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings from this scoping review highlight the rapid evolution of smart balance systems, yet significant gaps remain in AI integration, remote accessibility, and clinician-driven data analytics. Despite limitations such as cost, accessibility, and user training requirements, TeleRe","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e69589"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New, Portable Orofacial Manometer for Measuring Tongue Strength and Endurance in Children: Laboratory-Based Validity Study.","authors":"Rizky Kusuma Wardhani, Luh Karunia Wahyuni, Widjajalaksmi Kusumaningsih, Sarworini Bagio Budiardjo, Prasandhya Astagiri Yusuf, Sri Mardjiati Mei Wulan, Aria Kekalih, Titis Prawitasari, Sawitri Darmiati, Boya Nugraha","doi":"10.2196/68967","DOIUrl":"10.2196/68967","url":null,"abstract":"<p><strong>Background: </strong>An accurate tongue strength and endurance assessment is necessary for pediatric dysphagia. TongueFit is a new, portable orofacial manometer for measuring tongue strength and endurance and a game-based training app for children.</p><p><strong>Objective: </strong>This study aimed to test the validity of TongueFit compared with a standard manometer as the current gold standard for measuring air pressure.</p><p><strong>Methods: </strong>This laboratory study compared TongueFit and a standard manometer as the gold standard for measuring air pressure. This study was conducted in 3 different experimental conditions. The first experiment compared TongueFit and the standard manometer using a force tester (MCT-2150), with pressure controlled by MSatLite software. The second and third experiments involved 2-cm and 3-cm bulbs between the 2 devices. This study used Lin concordance correlation to measure the level of agreement.</p><p><strong>Results: </strong>There was a mean absolute difference of 0.005 kilopascals (kPa) between the TongueFit and the standard manometer (n=35, ρC=1). Statistical analysis showed perfect agreement correlation (ρC=1). By using the 2-cm bulb, TongueFit's mean was 0.007 kPa lower, also showing perfect agreement (ρC=1). Furthermore, using the 3-cm bulb, results showed almost perfect agreement (ρC=0.999) with the TongueFit's mean, which was 0.044 kPa lower.</p><p><strong>Conclusions: </strong>This study confirms the high validity of TongueFit as an orofacial manometer compared with a standard manometer, with negligible mean differences, as well as near-perfect and perfect agreement in the experiments. These results confirm that TongueFit is a valid and accurate tool for assessing tongue strength.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68967"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Method for Custom-Contoured Cushion Fabrication Based on Pressure Mapping for Wheelchair Users to Prevent Pressure Ulcers: Feasibility Quasi-Experimental Study.","authors":"Alma De León-Hernández, Adriana Martínez-Hernández, Isabel Bolivar-Tellería, Andrea Bosch-Sánchez, María Fernanda Cabrera-Padilla, Carlos Omar López-López","doi":"10.2196/68612","DOIUrl":"10.2196/68612","url":null,"abstract":"<p><strong>Background: </strong>Pressure ulcers constitute a major health care burden, characterized by significant morbidity, diminished quality of life, and elevated treatment costs. Wheelchair users are predisposed to pressure ulcers due to sustained ischial and sacral interface pressures resulting from prolonged periods of sitting. Implementation of pressure-relieving interventions, including specialized seating systems engineered to redistribute load and augment the weight-bearing surface area, is critical for mitigating the risk of pressure ulcers.</p><p><strong>Objective: </strong>This study aimed to evaluate a methodology for the custom fabrication of pressure relief cushions, through the user-cushion interface pressure mapping to reduce high-pressure areas and increase contact area in wheelchair users.</p><p><strong>Methods: </strong>First, a validation study was carried out with 7 healthy volunteers. The pressure was determined with an FSA sensor (BodiTrak BT1510, Vista Medical Manufactures), and the cushion profile was obtained through a linear relation with pressure values. In the second phase, 10 cushions for wheelchair users were manufactured and tested. The resulting data from buttock pressure using a flat foam, Jay X2 (gel-foam), ROHO high profile (air), and customed-contoured cushions were analyzed and compared using the following 4 variables: peak pressure, peak pressure index, mean pressure, and contact area.</p><p><strong>Results: </strong>In the validation study, the statistically significant difference between the flat and the custom-contoured cushion showed a better performance in pressure relief for the custom cushion (mean pressure 27.3, SD 4.5 mm Hg and 34.6, SD 3.5 mm Hg; P<.001). Regarding the study with wheelchair users, custom-contoured cushions had lower peak pressure (mean 91.3, SD 36 mm Hg), peak pressure index (mean 69.5, SD 33.7 mm Hg), and mean pressure (34.2, SD 17.4 mm Hg) against flat, Jay X2, and ROHO high profile cushions (P<.005). The contact area (mean 1457.6, SD 254.1 cm2) was greater for the contoured cushion (P<.001) than for flat and ROHO high profile (Permobile) cushions; nevertheless, it was not significantly different from Jay X2 (P=.59).</p><p><strong>Conclusions: </strong>The main finding is that the buttock pressure mapping method produces custom-contoured cushions that, compared with commercial cushions, have good pressure distribution and increased contact area. These results suggest that pressure mapping is a good alternative for manufacturing affordable custom-contoured cushions that can prevent the development of pressure ulcers.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e68612"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Compassionate Care in Virtual Rehabilitation: Qualitative Study.","authors":"Parminder Flora, Angela Tobia, Lee Verweel, Bernice Lau, Janet Campbell, Arezoo Eshraghi, Steven Dilkas, Roger Goldstein, Patricia Raulino, Crystal MacKay","doi":"10.2196/59157","DOIUrl":"10.2196/59157","url":null,"abstract":"<p><strong>Background: </strong>Virtually delivered health care services can offer numerous benefits, and the demand for virtual care continues to grow among subgroups facing mobility challenges. The experience of compassion in health care is linked to patient satisfaction and clinical outcomes; however, this link in virtual rehabilitation settings is underexplored.</p><p><strong>Objective: </strong>The objectives of this study were to explore what compassionate care means to rehabilitation patients in a virtual rehabilitation context and explore patients' experiences of how the technology associated with virtual rehabilitation impacted their experience of care.</p><p><strong>Methods: </strong>We conducted one-on-one semistructured qualitative interviews with patients with limb loss and chronic obstructive pulmonary disease. A reflexive thematic analysis approach was used to generate domain summaries and initial themes across the sample. Themes were generated following analytic work over a series of discussions within the research team.</p><p><strong>Results: </strong>Sixteen interviews were conducted. Four themes illustrating participants' perceptions of compassionate care were generated: (1) features of compassionate care include feeling valued, connected, and cared for by the health care provider; (2) threats to compassionate care in virtual rehabilitation; (3) facilitating compassion in virtual rehabilitation through preparation; and (4) benefits of virtual care.</p><p><strong>Conclusions: </strong>Patient perceptions of compassionate care in a virtual rehabilitation setting may be impacted by the behaviors and communication of providers. Provider training and preparation and the personal connections formed with their patients may impact compassionate care experiences.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e59157"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholders and Contextual Factors in the Implementation of Assistive Robotic Arms for Persons With Tetraplegia: Deductive Content Analysis of Focus Group Interviews.","authors":"Vera Fosbrooke, Marco Riguzzi, Anja M Raab","doi":"10.2196/65759","DOIUrl":"10.2196/65759","url":null,"abstract":"<p><strong>Background: </strong>Tetraplegia imposes significant challenges on affected individuals, caregivers, and health care systems. Assistive technologies (ATs) such as assistive robotic arms have been shown to improve the quality of life of persons with tetraplegia, fostering independence in daily activities and reducing caregiver burden. Despite potential benefits, the integration of AT innovations into daily life remains difficult. Implementation science offers a systematic approach to bridge this know-do gap.</p><p><strong>Objective: </strong>This study aimed to (1) identify and involve relevant stakeholders; (2) identify relevant contextual factors (barriers and facilitators); and (3) suggest a general outlook for the implementation of AT, specifically an assistive robotic arm, into the everyday private lives of individuals with tetraplegia in Switzerland.</p><p><strong>Methods: </strong>A qualitative design was used, involving 3 semistructured online focus group interviews with 8 stakeholder groups, including persons with tetraplegia as well as those who could provide perspectives on engineering or technology, legal matters, nursing or care, therapy, social counseling, social insurance, and political considerations. The interviews were analyzed using the Focus Group Illustration Mapping tool, and the data were aligned with the domains of the Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>3 focus group interviews comprising 22 participants were conducted, and data were mapped onto 21 constructs across the Consolidated Framework for Implementation Research domains. Identified barriers were customization to users' needs, safety concerns, and financing issues for the high AT costs. The collaboration with different stakeholders, including those who provided perspectives on political engagement, proved crucial. Identified facilitators included the enhancement of autonomy for persons with tetraplegia, improvement of quality of life, reduction of caregiver dependency, and addressing health care labor shortages. The implementation outlook involved the formation of an experienced team and the development of an implementation plan using hybrid type 1 and type 2 designs that incorporate both qualitative and quantitative implementation and innovation outcomes.</p><p><strong>Conclusions: </strong>Robotic arms offer promising benefits in terms of improved participation for users, while high costs and regulatory complexities as to who will assume these costs limit their implementation. These findings highlight the complexities involved in implementing AT innovations and the importance of addressing contextual factors. A specific framework for the implementation of AT is needed to ensure the successful integration in Switzerland and other countries with comparable social and health insurance systems.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e65759"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Gait Kinematics With Ramp and Stair Ascent and Descent Revealed by Markerless Motion Capture in Simulated Living Space: Test-Retest Reliability Study.","authors":"Daiki Shimotori, Kenji Kato, Tatsuya Yoshimi, Izumi Kondo","doi":"10.2196/66886","DOIUrl":"10.2196/66886","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an increasing demand for markerless motion capture systems, which are being widely used in biomechanical and clinical research. Furthermore, by using a markerless motion capture system in a laboratory environment that mimics living spaces, the data acquired on various activities of daily living, such as level walking, ramp walking, and stair ascent and descent, should more closely resemble that of real-life activities. However, the absolute reliability of gait parameters in this context is still unclear.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the reliability of a markerless motion capture system in assessing the ascent and descent of ramps and stairs during walking in a simulated living space.</p><p><strong>Methods: </strong>A total of 21 healthy participants performed level walking, ramp and stair ascent and descent on two separate days, with at least a 24-hour interval between sessions. Joint angles were measured using 27 synchronized cameras with a markerless motion capture application, Theia3D (Theia Markerless Inc), and analyzed in Visual3d for all planes of motion at the hip-, knee-, and ankle-joints. The absolute reliability of day-to-day reproducibility was assessed using full-curve analysis (root mean square difference [RMSD]) and discrete point analysis of gait events using the standard error of measurement (SEM). SEM was calculated only for level walking and ramp ascent and descent, where gait events were correctly detected.</p><p><strong>Results: </strong>The SEM values for level walking and ramp ascent and descent were all below the 5-degree threshold. However, while RMSD values were generally below 5°, this threshold was exceeded for knee-joint flexion-extension angles during ramp ascent and stair ascent (5.07° and 5.64°, respectively).</p><p><strong>Conclusions: </strong>The markerless motion capture system in the living laboratory setting demonstrated a high degree of accuracy for various environments and gait types. The low SEM values obtained indicate good reliability for joint angle measurements across different days. The slightly higher RMSD values for knee-joint angles during ramp and stair ascent may reflect the system's ability to capture the adaptations in joint kinematics in response to changes in gait conditions. These measurements in a living laboratory environment validated the absolute reliability of various gait parameters not only in level walking but also in ramp and stair ascent and descent. The findings suggest potential clinical applications and research opportunities, including the development of assistive devices and robots, using markerless motion capture in more natural living situations, rather than in controlled environments.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"12 ","pages":"e66886"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}